Surreal illustration of a healthy esophagus promoting wellness.

Understanding Achalasia: Incidence, Symptoms, and Modern Treatments

Elliot Brynn in Health & Wellness August 2025 • 4 min read.

"New research sheds light on the prevalence and management of achalasia, offering hope for those affected by this rare esophageal disorder."

Achalasia is a rare and often misunderstood disorder that affects the esophagus, the tube that carries food from your mouth to your stomach. Characterized by the absence of peristalsis (the coordinated muscle contractions that move food along) and impaired relaxation of the lower esophageal sphincter (LES), achalasia can make eating and drinking a challenging and uncomfortable experience.

While the exact cause of achalasia remains elusive, scientists believe it involves a combination of factors, including the loss of ganglion cells in the myenteric plexus, the nerve network controlling esophageal muscle function. This loss is thought to stem from inflammatory or neurodegenerative processes, possibly triggered by viral infections or autoimmune reactions. Understanding the triggers and mechanisms behind achalasia is crucial for developing effective treatments and potentially even preventive strategies.

Worldwide, achalasia affects approximately 10 out of every 100,000 people, with fewer than 1 in 100,000 newly diagnosed each year. Because of its rarity, epidemiological information is limited, and studies often rely on local hospital records, primarily in Western countries. Recent research from Korea, leveraging a comprehensive national healthcare database, provides valuable insights into the epidemiology and treatment patterns of achalasia in a more genetically homogenous population.

Key Findings from the Korean Study

Surreal illustration of a healthy esophagus promoting wellness.

A groundbreaking study utilizing Korea's national healthcare database has illuminated key aspects of achalasia within the Korean population. This research identified 3,105 patients diagnosed with achalasia between 2007 and 2011, revealing a prevalence of 6.29 cases per 100,000 individuals. In 2011 alone, 191 new cases were identified, translating to an incidence rate of 0.39 per 100,000 people. These figures offer a crucial snapshot of the disease's presence and spread within the country.

The study underscores that achalasia can manifest at any stage of life, although it is more frequently diagnosed in individuals over the age of 50. Interestingly, only a small fraction of cases (2%) were found in children under 10 years old. This age distribution pattern contributes to our understanding of the disease's development and progression across different life stages.

Prevalence: 6.29 cases per 100,000 individuals.
Incidence: 0.39 new cases per 100,000 people annually.
Age Distribution: More prevalent in individuals over 50.
Treatment Modalities: Predominantly pneumatic balloon dilation.

The research also investigated current treatment approaches for achalasia, revealing a preference for pneumatic balloon dilation over surgical esophagomyotomy. During the study period, balloon dilation therapy was performed 975 times in 719 patients, while surgical intervention was far less common, with only 17 patients undergoing esophagomyotomy. This disparity highlights the prevailing treatment strategies and the expertise available in Korea.

Implications and Future Directions

This study offers valuable insights into the epidemiology of achalasia in Korea, highlighting its incidence, demographic features, and preferred treatment modalities. The findings suggest that treatment strategies in Korea may differ from those in Western countries, with a stronger emphasis on pneumatic balloon dilation. Further research is needed to explore the reasons behind these differences and to optimize treatment outcomes for patients with achalasia worldwide. By continuing to investigate the causes, risk factors, and optimal management approaches for achalasia, we can improve the quality of life for those affected by this challenging condition.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.3346/jkms.2014.29.4.576, Alternate LINK

Title: Achalasia In Korea: An Epidemiologic Study Using A National Healthcare Database

Subject: General Medicine

Journal: Journal of Korean Medical Science

Publisher: Korean Academy of Medical Sciences

Authors: Eunkyung Kim, Hongsub Lee, Hye-Kyung Jung, Kwang Jae Lee

Published: 2014-01-01

Everything You Need To Know

What exactly is achalasia, and what are the underlying mechanisms believed to cause it?

Achalasia is a rare esophageal disorder characterized by the absence of peristalsis and impaired relaxation of the lower esophageal sphincter (LES). This means the esophagus can't properly move food to the stomach, leading to difficulty swallowing and discomfort. While the exact cause is unknown, it's believed to involve the loss of ganglion cells in the myenteric plexus, which controls esophageal muscle function. This loss may result from inflammatory or neurodegenerative processes, possibly triggered by viral infections or autoimmune reactions.

What insights did the Korean study provide regarding the prevalence and incidence of achalasia in their population?

The recent study in Korea, utilizing their national healthcare database, found a prevalence of 6.29 cases of achalasia per 100,000 individuals. In 2011, the incidence rate was 0.39 new cases per 100,000 people. This data is significant because epidemiological information about achalasia is limited due to its rarity, and this comprehensive study provides a clearer picture of its occurrence in a genetically homogenous population.

What does the Korean research indicate about the age distribution of individuals diagnosed with achalasia?

The Korean study revealed that while achalasia can occur at any age, it is more frequently diagnosed in individuals over 50 years old. Only a small percentage, about 2%, of cases were found in children under 10. This age distribution helps in understanding the disease's progression and development across different life stages. Understanding at what age achalasia typically emerges is vital for targeted screening and timely intervention.

What treatment modalities are preferred for achalasia in Korea, according to the research?

In Korea, pneumatic balloon dilation is the preferred treatment approach for achalasia over surgical esophagomyotomy. During the study period, balloon dilation was performed significantly more often than surgical intervention. Pneumatic balloon dilation involves inflating a balloon inside the lower esophageal sphincter (LES) to stretch and weaken the muscle, making it easier for food to pass through. Esophagomyotomy, on the other hand, is a surgical procedure to cut the muscles of the LES. The prevalence of pneumatic balloon dilation suggests it is considered a less invasive and effective option in the studied region.

What are the implications of the Korean study's findings regarding differences in achalasia treatment strategies compared to Western countries, and what further research is needed?

The study highlights that treatment strategies for achalasia in Korea may differ from those in Western countries, with a stronger emphasis on pneumatic balloon dilation. This could be due to differences in medical practices, available resources, or patient preferences. More research is needed to understand why these differences exist and to determine the most effective treatment approaches for patients worldwide. Factors such as access to specialized medical centers, physician training, and healthcare policies could influence treatment choices. Further investigation into these disparities is crucial for optimizing patient outcomes globally.